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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197801985
Report Date: 10/07/2025
Date Signed: 10/07/2025 08:30:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/01/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251001092918
FACILITY NAME:LOVE N CARE GUEST HOMEFACILITY NUMBER:
197801985
ADMINISTRATOR:BRILLANTES, HARRYFACILITY TYPE:
735
ADDRESS:11866 E. 162ND. ST.TELEPHONE:
(562) 404-7601
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:8CENSUS: 8DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Luz Brillantes - AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff does not ensure resident's hygiene needs are being met.
Staff does not ensure resident's bedroom is kept clean.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to
investigate the above allegations. LPA met with Luz Brillantes, Administrator and explained the purpose of
the visit.

The investigation consisted of the following: LPA obtained copies of the staff & client rosters and Client #1 (C1)'s pertinent files such as: Identification/Emergency Information, Admission Agreement, Physician's report, Need/Services Plan. LPA interviewed Staff #1 (S1) - Staff #2 (S2) and Client #1 (C1) - Client #5 (C5).

The investigation revealed the following:
Allegation: "Staff does not ensure resident's hygiene needs are being met". It is alleged that C1 has poor hygiene and has bed bug bites all over their body. Interviewed staff indicated that they assist clients with their daily activities like bathing, but cannot force them to bathe if they refuse.
*****CONTINUED ON LIC9099-C*****
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 5
Control Number 28-AS-20251001092918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LOVE N CARE GUEST HOME
FACILITY NUMBER: 197801985
VISIT DATE: 10/07/2025
NARRATIVE
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     Staff stated they provide personal hygiene supplies to C1 and other clients at home. (5) out of (5) clients interviewed stated they bathe on their own and that staff are ready to assist if needed. Client interviews revealed that they do not have any concerns regarding this matter. C1 stated they take a bath every other day as per the Administrator's instruction. During the interviews, clients appeared clean and their rooms were odor-free. There is not enough evidence to support this allegation.

    Allegation: "Staff does not ensure resident's bedroom is kept clean." It is alleged that staff instructed C1 to clean their room which is hoarded with clothes which block the passage of the bedroom door. Interviewed staff stated that C1 has a habit of hoarding clothes and other items but staff help organize C1's bedroom. Staff indicated that they took C1's extra clothes to the back storage to make the room accessible. Interviewed staff stated that they clean the home regularly, including clients’ bedrooms, and sometimes clients help with cleaning their own rooms. (5) out of (5) client interviewed stated that staff clean their rooms and they do not have any concerns regarding this matter. During the facility tour, LPA observed C1's room to be clean with nothing blocking the door. Interviews and observation do not corroborate this allegation.

    Based on LPA’s observations, interviews, and record reviews, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

    Exit interview held with Luz Brillantes, Administrator and a copy of this report was provided to Irene Smith, Caregiver.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/01/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251001092918

FACILITY NAME:LOVE N CARE GUEST HOMEFACILITY NUMBER:
197801985
ADMINISTRATOR:BRILLANTES, HARRYFACILITY TYPE:
735
ADDRESS:11866 E. 162ND. ST.TELEPHONE:
(562) 404-7601
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:8CENSUS: 8DATE:
10/07/2025
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Luz Brillantes - AdministratorTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff does not ensure facility is free of bed bugs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced initial complaint visit to
investigate the above allegation. LPA met with Luz Brillantes, Administrator and explained the purpose of
the visit.

The investigation consisted of the following: LPA obtained copies of the staff & client rosters, and Client #1 (C1)'s pertinent files such as: Identification/Emergency Information, Admission Agreement, Physician's report, Need/Services Plan. LPA interviewed Staff #1 (S1) - Staff #2 (S2) and Client #1 (C1) - Client #5 (C5).

The investigation revealed the following:
Allegation: "Staff does not ensure facility is free of bed bugs." It is alleged that C1's bed, clothing and self are infested with bedbugs. It is also alleged that it was brought to the staff's attention but the problem has not been addressed. Staff interviewed confirmed the presence of bed bugs in C1's bed but did not call the exterminator. *****CONTINUED ON LIC9099-C*****
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20251001092918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LOVE N CARE GUEST HOME
FACILITY NUMBER: 197801985
VISIT DATE: 10/07/2025
NARRATIVE
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 S1 stated that the facility does not have an ongoing or scheduled pest/bug control service. Instead, staff interviewed stated they spray alcohol and regular bug spray on C1's bed and room daily. (5) out of (5) clients interviewed confirmed seeing bed bugs and other type of bugs in the home. C1 stated seeing bed bugs on the mattress and feeling itchy from bites. Some clients interviewed stated seeing bed bugs on the living room couch. During the facility tour, LPA observed bed bugs in C1 & C2’s mattresses. Therefore there was sufficient evidence to corroborate with this allegation.

Based on LPA’s observations, interviews, and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Deficiency cited on the attached LIC 9099D. An exit interview was conducted with Luz Brillantes, Administrator and a copy of this report was provided to Irene Smith, Caregiver along with the Appeals Rights.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20251001092918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: LOVE N CARE GUEST HOME
FACILITY NUMBER: 197801985
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2025
Section Cited
CCR
80087(a)(1)
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80087 Buildings and Grounds..(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients,..(1) The licensee shall take measures to keep the facility free of flies and other insects.
This requirement is not met as evidenced by:

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Administrator agreed to dispose C1's mattress and purchase a new one. Additionally, Administrator will maintain a contract with pest control company to address the bed bug problem, until the facility is free of bed bugs. CONT....

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During the facility inspection, LPA observed bed bugs in C1-C2's mattresses in their bedroom which revealed and confirmed active bedbugs which poses an immediate health and safety risk to clients in care.
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Administrator will comply with all recommendations given by pest control company. Administrator will send photos/receipt of the new mattress and the exterminator contract from the pest control company to CCL/ LPA by POC due date.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5